Distinguished Service Award Nomination Form

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AASA begins accepting nominations in April annually.

Nominations must be completed via the form below by September 1.

At least two but no more than four pages of additional data must be attached to the nomination form below.

No publications or additional testimonials will be accepted.

Nominees must meet the following criteria:

Has been an AASA member for at least 10 years
Has been retired for at least one year
Has brought honor to themselves, their colleagues and their profession
Has given exemplary service to their state or national professional association
Has made significant contributions to the field of education through their service, writings and other activities

* denotes required field

Nominee Information

Name of Nominee*

Address of Nominee*

Please include street address, city, state, and zip code.

Phone Number of Nominee

Email of Nominee*

Last Full-Time Position Held by Nominee*

Date Retired*

Include Month & Year

Nominee Accomplishments

List three leadership positions the nominee held in school administration or related to school administration.*

List significant accomplishments of nominee during career. (Maximum of three)*

Indicate local, state and national honors that nominee has received. (Maximum of three)*

What has nominee done to advance school administration or education in state or area served? Do not include offices here. (Cite a maximum of three specific examples.)*

Has nominee made a contribution in education or school administration that has had a national impact?*

Yes

If Yes, please explain:

Has the nominee produced any writing that has been published statewide or nationally?*

Yes

If Yes, please list a maximum of 3 under each category below

Book(s)

Article(s)

Please list any state educational organization offices held by the nominee (maximum of three):

Include organization name and position held

Please list any national educational organization offices held by the nominee (maximum of three):

Include organization name and position held

Indicate other professional or personal responsibilities of significance that were assumed by nominee. (Maximum of three).

Some person may be nominated for which this form is inappropriate to use in establishing that person’s eligibility for nomination. If so, please attach a statement of no more than two pages which would cite the person’s uniqueness that justifies receiving a Distinguished Service Award.

Please attach no less than two and no more than four pages citing other items that ought to be reviewed when considering the nominee.*

Add another

Has the nominee been a member of AASA for at least ten years?*

Yes

If known, please provide dates of AASA membership.

Nominator Information

Full Name*

Address*

Please include street, city, state and zip code.

Phone Number*

Email*

New code

Please type the code above

Please Note: If you hit the submit button and are not taken to a confirmation message, you are missing a required field. Please review the form and fill out all required fields to successfully submit your nomination.